Current Procedural Terminology (CPT®) emergency department (ED) evaluation and management (E/M) codes 99281–99285 can only be reported when care is provided in an ED that is an organized hospital-based facility for the provision of unscheduled episodic services to patients who present for immediate medical attention and when the facility is available 24 hours a day.

Because primary care pediatricians often are called on to provide care and advice for the management of children in the ED and only one physician can report an ED E/M service on a given day of service, physicians need to understand how to accurately report services provided in the ED. The following should provide some guidance when reporting services provided in the ED:

You are the primary physician managing the patient in the ED (ie, ED physician or physician meeting his or her patient in the ED), or you have been asked to...

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